Shoheli Alam, K. Islam, A. Ullah, T. Siddiqui, R. Amin
Objective: The aim of this study is to evaluate the management of inguinal hernias in children as a day case surgery in elective basis. Methods: From July 2011 to June 2014, 141 infants and children with inguinal hernias were seen, operated on, and followed up as outpatient procedure in the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh (BSMMU) Age, sex, side of hernia, presence of an associated hydrocele/ undescended testes/ VPshunt, occurrence of contralateral hernia, clinical aspects of these patients, type of surgery, mortality, and mobidity were studied Results: The ages ranged from 2months to 14 years (mean age, 6.28 years) with a male-to female ratio of 3:1. There were 59.6% right, 34.8% left, and 5.7% bilateral hernias (all are indirect variety).The most common associated anomaly was hydrocele in 29(20.8%)patients, undescended testis in 9(6.5%) patients and in 4(2.8%) patients had ventriculoperitoneal shunt. The content of the hernial sac in 56(39.7%) patients were omentum and next were intestine in 30(21.3%) patients. Overall, there were 13 (9.2%) sliding hernias. Among them in five case of boys four (80%) patients contents were cecum and one (20%) patient was sigmoid colon. In case of girls, contents were ovaries in all eight patients. Contralateral groin exploration was not done of any patients at the initial hernia repair. There were recurrences in 2(1.4%) patients, 13(9%) patients developed wound infections, and 21(15%) patients had scrotal haematocele. There were no postoperative deaths. A contralateral hernia developed in three (2%) children within one year after the initial repair. Conclusions: Inguinal hernia is a common surgical condition in children. Elective surgery is associated with minimal morbidity. A routine contralateral groin exploration is not done at the initial hernia repair J. Paediatr. Surg. Bangladesh 6 (2): 34-38, 2015 (July)
{"title":"Three Years Experience of Inguinal Hernia in Children in BSMMU","authors":"Shoheli Alam, K. Islam, A. Ullah, T. Siddiqui, R. Amin","doi":"10.3329/JPSB.V6I2.27747","DOIUrl":"https://doi.org/10.3329/JPSB.V6I2.27747","url":null,"abstract":"Objective: The aim of this study is to evaluate the management of inguinal hernias in children as a day case surgery in elective basis. Methods: From July 2011 to June 2014, 141 infants and children with inguinal hernias were seen, operated on, and followed up as outpatient procedure in the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh (BSMMU) Age, sex, side of hernia, presence of an associated hydrocele/ undescended testes/ VPshunt, occurrence of contralateral hernia, clinical aspects of these patients, type of surgery, mortality, and mobidity were studied Results: The ages ranged from 2months to 14 years (mean age, 6.28 years) with a male-to female ratio of 3:1. There were 59.6% right, 34.8% left, and 5.7% bilateral hernias (all are indirect variety).The most common associated anomaly was hydrocele in 29(20.8%)patients, undescended testis in 9(6.5%) patients and in 4(2.8%) patients had ventriculoperitoneal shunt. The content of the hernial sac in 56(39.7%) patients were omentum and next were intestine in 30(21.3%) patients. Overall, there were 13 (9.2%) sliding hernias. Among them in five case of boys four (80%) patients contents were cecum and one (20%) patient was sigmoid colon. In case of girls, contents were ovaries in all eight patients. Contralateral groin exploration was not done of any patients at the initial hernia repair. There were recurrences in 2(1.4%) patients, 13(9%) patients developed wound infections, and 21(15%) patients had scrotal haematocele. There were no postoperative deaths. A contralateral hernia developed in three (2%) children within one year after the initial repair. Conclusions: Inguinal hernia is a common surgical condition in children. Elective surgery is associated with minimal morbidity. A routine contralateral groin exploration is not done at the initial hernia repair J. Paediatr. Surg. Bangladesh 6 (2): 34-38, 2015 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129937445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mondal, A. Z. Hossain, Md. Mahbubur Rahman, G. Z. Hasan, K. Hasina, Nuruzzaman
Appendicitis is one of the most common causes of acute abdominal pain in pediatrics and is the most common indication for emergency abdominal surgery in childhood. The diagnosis of pediatric appendicitis remains challenging. To evaluate the role of pediatric appendicitis score (PAS) in the diagnosis of appendicitis of children. Methods: In this study, 200 suspected appendicitis patients attended in four private hospitals in old Dhaka city over a period of about 34 months from January 2011 to May 2014 were selected as study subjects. Patient age, sex and each of the eight PAS components were collected. Children who had PAS less than six were discharged and contacted by telephone upto 1 month to verify final outcome. Rest of the children with PAS equal or more than 6 were underwent appendectomy. Results: Two hundred patients were assessed in this study. Out of them 67 (33.5%) children had appendicitis and 76 (38.0%) children had PAS equal or more than 6. In appendicitis children, maximum (85.3%) children were in age group 10- 16 years and 10 (14.7%) patients were in age group 5-9 years. Male (73.5%) were predominant than female (26.5%) in appendicitis children. Migration of pain, nausea and anorexia were in 43 (63.2%), 45 (66.2%) and 48 (70.6%) appendicitis children respectively. Fever, cough/percussion tenderness and tenderness in RLQ were in 37 (54.4%), 52 (76.5%) and 59 (86.8%) appendicitis children respectively. Leukocytosis andneutophilia were present in 42 (61.8%) and 46 (67.6%) appendicitis children respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rate of PAS were 80.6%, 83.5%, 71.1%, 89.5% and 82.5% respectively. Conclusion: Paediatric Appendicitis Score is a good tool but not good enough for diagnosis of paediatirc appedicitis. It cannot be recommended for diagnosis of paediatric appendicitis because its negative appendicectomy rate as well as wrongly discharged rate is high. J. Paediatr. Surg. Bangladesh 6 (1): 16-19, 2015 (Jan)
{"title":"Diagnostic Role of Pediatric Appendicitis Score (PAS) in Appendicitis of Children","authors":"S. Mondal, A. Z. Hossain, Md. Mahbubur Rahman, G. Z. Hasan, K. Hasina, Nuruzzaman","doi":"10.3329/JPSB.V6I1.27742","DOIUrl":"https://doi.org/10.3329/JPSB.V6I1.27742","url":null,"abstract":"Appendicitis is one of the most common causes of acute abdominal pain in pediatrics and is the most common indication for emergency abdominal surgery in childhood. The diagnosis of pediatric appendicitis remains challenging. To evaluate the role of pediatric appendicitis score (PAS) in the diagnosis of appendicitis of children. Methods: In this study, 200 suspected appendicitis patients attended in four private hospitals in old Dhaka city over a period of about 34 months from January 2011 to May 2014 were selected as study subjects. Patient age, sex and each of the eight PAS components were collected. Children who had PAS less than six were discharged and contacted by telephone upto 1 month to verify final outcome. Rest of the children with PAS equal or more than 6 were underwent appendectomy. Results: Two hundred patients were assessed in this study. Out of them 67 (33.5%) children had appendicitis and 76 (38.0%) children had PAS equal or more than 6. In appendicitis children, maximum (85.3%) children were in age group 10- 16 years and 10 (14.7%) patients were in age group 5-9 years. Male (73.5%) were predominant than female (26.5%) in appendicitis children. Migration of pain, nausea and anorexia were in 43 (63.2%), 45 (66.2%) and 48 (70.6%) appendicitis children respectively. Fever, cough/percussion tenderness and tenderness in RLQ were in 37 (54.4%), 52 (76.5%) and 59 (86.8%) appendicitis children respectively. Leukocytosis andneutophilia were present in 42 (61.8%) and 46 (67.6%) appendicitis children respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy rate of PAS were 80.6%, 83.5%, 71.1%, 89.5% and 82.5% respectively. Conclusion: Paediatric Appendicitis Score is a good tool but not good enough for diagnosis of paediatirc appedicitis. It cannot be recommended for diagnosis of paediatric appendicitis because its negative appendicectomy rate as well as wrongly discharged rate is high. J. Paediatr. Surg. Bangladesh 6 (1): 16-19, 2015 (Jan)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132357134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. N. F. Rumi, S. Ahmad, S. Rahman, Abdul Hanif Tablu
Background: Thyroglossal duct cyst a developmental anomaly present as a congenital cervical masses of neck in children. Objectives: To observe its deferent presentation and evaluate among the children. Materials and methods: This observational cross section study conducted among patients of eighteen years of age present with thyroglossal duct cyst between 2007 to 2012 in the department of ENT and Head- Neck surgery, Dhaka Medical College Hospital, Dhaka. All patients were operated by Sistrunk operation under (excision of total cyst and removal median portion hyoid bone) under general anesthesia. All specimens were histo-pathologically confirmed. Results: Among 24 children with thyroglossal cyst, 15 boys and 9 girls with male female ratio 1.67:1, age ranged from 4 years to 18 years (mean 9.46 std ±4.27). Male (mean 7.53±4.01years) child are younger than female (mean 12.67±2.39 years) child. 66.67% male children were below 10 years of age and 88.89% female children were over 10 years of age. According to the presentation site 17(70.83%) cases were juxtra hyoid, 4(16.67%) were suprahyoid and 3 (12.50%) were infrahyoid. 23 (95.83%) were present as midline swelling, only 1(4.17%) was present as left lateral infrahyoid swelling. 4(16.67%) patient were attended as thyroglossal fistulae with history of intervention. 4(16.67%) patient were developed recurrence followed by surgical resection within two years. Conclusion: Thyroglossal duct cyst present as an asymptomatic midline neck mass around the hyoid region in children. Complete resection along with median portion hyoid bone prevents recurrence. J. Paediatr. Surg. Bangladesh 5 (2): 45-53, 2014 (July)
{"title":"Presentation of Thyroglossal Cyst in Children","authors":"S. N. F. Rumi, S. Ahmad, S. Rahman, Abdul Hanif Tablu","doi":"10.3329/JPSB.V5I2.27724","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27724","url":null,"abstract":"Background: Thyroglossal duct cyst a developmental anomaly present as a congenital cervical masses of neck in children. Objectives: To observe its deferent presentation and evaluate among the children. Materials and methods: This observational cross section study conducted among patients of eighteen years of age present with thyroglossal duct cyst between 2007 to 2012 in the department of ENT and Head- Neck surgery, Dhaka Medical College Hospital, Dhaka. All patients were operated by Sistrunk operation under (excision of total cyst and removal median portion hyoid bone) under general anesthesia. All specimens were histo-pathologically confirmed. Results: Among 24 children with thyroglossal cyst, 15 boys and 9 girls with male female ratio 1.67:1, age ranged from 4 years to 18 years (mean 9.46 std ±4.27). Male (mean 7.53±4.01years) child are younger than female (mean 12.67±2.39 years) child. 66.67% male children were below 10 years of age and 88.89% female children were over 10 years of age. According to the presentation site 17(70.83%) cases were juxtra hyoid, 4(16.67%) were suprahyoid and 3 (12.50%) were infrahyoid. 23 (95.83%) were present as midline swelling, only 1(4.17%) was present as left lateral infrahyoid swelling. 4(16.67%) patient were attended as thyroglossal fistulae with history of intervention. 4(16.67%) patient were developed recurrence followed by surgical resection within two years. Conclusion: Thyroglossal duct cyst present as an asymptomatic midline neck mass around the hyoid region in children. Complete resection along with median portion hyoid bone prevents recurrence. J. Paediatr. Surg. Bangladesh 5 (2): 45-53, 2014 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126322017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Hasina, A. Alamgir, Sm Sabbir Enayet, A. Hanif, M. Pervez, Saima Alam
Introduction: Myelomeningocele is a single most common congenital malformation that affects the entire central nervous system and because of extensive internal CNS involvement, its management remains controversial. Proper management of affected children can lead to a meaningful and productive life, and poorly managed cases of myelomeningocele can be a devastating obstacle not only for patient but also for the patient’s family. Materials and methods: This was a descriptive study, started in January, 2007 and completed in December 2014 in the Department of Pediatric Surgery and Department of Neurosurgery of Dhaka Medical College & Hospital (DMCH).The medical records of 42 children with myelomeningocele operated at our center were reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied. Results: The age of most of the patients at the time of myelomeningocele repair was between 45 days to 60 days; however, children with ruptured myelomeningocele were consistently repaired early after controlling infection. In our study, 16 patients (38.1%) of myelomeningocele with hydrocephalus were operated for medium pressure ventriculoperitoneal (VP) shunt first, and then repair after 7 days to 10 days. VP shunt was done 7 days after repair of myelomeningocele in 11 patients (26.19%), who developed hydrocephalus postoperatively. All 8 patients with ruptured myelomeningocele (19.05%) were treated for ventriculitis first, then by repair. Seven patients (16.67%) with intact lesion were repaired between 4 weeks to 8 weeks of age. Complications including CSF leak, wound infection, wound dehiscence, paraplegia, autonomic incontinence, shunt infection and malfunction after repair of myelomeningocele occurred in 27 patients (64.29%). Six patients (14.29%) died during treatment protocol. All the patients were followed up postoperatively for 6 months to 1 year. Conclusion: Surgical intervention with or without VP shunt of patients with myelomeningocele produced good results. J. Paediatr. Surg. Bangladesh 5 (2): 54-57, 2014 (July)
{"title":"Management of Myelomeningocele: Eight Years Experience in Dhaka Medical College and Hospital","authors":"K. Hasina, A. Alamgir, Sm Sabbir Enayet, A. Hanif, M. Pervez, Saima Alam","doi":"10.3329/JPSB.V5I2.27725","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27725","url":null,"abstract":"Introduction: Myelomeningocele is a single most common congenital malformation that affects the entire central nervous system and because of extensive internal CNS involvement, its management remains controversial. Proper management of affected children can lead to a meaningful and productive life, and poorly managed cases of myelomeningocele can be a devastating obstacle not only for patient but also for the patient’s family. Materials and methods: This was a descriptive study, started in January, 2007 and completed in December 2014 in the Department of Pediatric Surgery and Department of Neurosurgery of Dhaka Medical College & Hospital (DMCH).The medical records of 42 children with myelomeningocele operated at our center were reviewed retrospectively. The surgical & medical management protocol used for different sites of myelomeningocele was studied. Results: The age of most of the patients at the time of myelomeningocele repair was between 45 days to 60 days; however, children with ruptured myelomeningocele were consistently repaired early after controlling infection. In our study, 16 patients (38.1%) of myelomeningocele with hydrocephalus were operated for medium pressure ventriculoperitoneal (VP) shunt first, and then repair after 7 days to 10 days. VP shunt was done 7 days after repair of myelomeningocele in 11 patients (26.19%), who developed hydrocephalus postoperatively. All 8 patients with ruptured myelomeningocele (19.05%) were treated for ventriculitis first, then by repair. Seven patients (16.67%) with intact lesion were repaired between 4 weeks to 8 weeks of age. Complications including CSF leak, wound infection, wound dehiscence, paraplegia, autonomic incontinence, shunt infection and malfunction after repair of myelomeningocele occurred in 27 patients (64.29%). Six patients (14.29%) died during treatment protocol. All the patients were followed up postoperatively for 6 months to 1 year. Conclusion: Surgical intervention with or without VP shunt of patients with myelomeningocele produced good results. J. Paediatr. Surg. Bangladesh 5 (2): 54-57, 2014 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130604345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pediatric surgical oncology is a relatively new and rapidly evolving field. Childhood neoplasia is generally not a public health priority in most developing countries. Although it is rare, pediatric cancer is a leading cause of childhood death in developed countries such as the United States. In the 1960s, almost 25% of global cancer burden was diagnosed in low-income and lower-middle-income countries. In 2010, nearly 55% of the global cancer burden was found in these countries.1 According to estimates from the International Agency for Research on Cancer (IARC), there were 12.7 million new cancer cases in 2008 worldwide, of which 5.6 million occurred in developed countries and 7.1 million in developing countries. Total cancer deaths in 2008 were 7.6 million (about 21,000 cancer deaths a day), 2.8 million in developed countries and 4.8 million in developing countries. By 2030, the global burden is expected to grow to 21.4 million new cancer cases and 13.2 million cancer deaths. Almost 9 million (about 70%) of these deaths will be in developing countries. By 2050, at the present growth rate, the chances of contracting cancer in their lifetime for the people living in developing countries will be 50-60%. Worldwide, approximately 10 million people are diagnosed with cancer annually and more than 6 million die of the disease every year; currently, over 22 million people in the world are cancer patients.4,5The cancer rate will increase from 650,000 to 2.2 million per year.4,5 In developed countries like United States, 11,600 new cases of pediatric malignancies are expected to be diagnosed in children aged 0-14 years in 2013. In 2008, GLOBOCAN has estimated that about 1, 48,000 malignancies in children aged 0–14 years occurred in less developed regions like Asia excluding Japan, Africa etc. having a population of 5.5 billion. There PEDIATRIC SURGICAL ONCOLOGY IN BANGLADESH: INCIDENCE AND PREVALENCE (GLOBAL & BANGLADESH)
{"title":"Pediatric Surgical Oncology in Bangladesh: Incidence and Prevalence (Global & Bangladesh)","authors":"K. Hasina","doi":"10.3329/JPSB.V5I2.27721","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27721","url":null,"abstract":"Pediatric surgical oncology is a relatively new and rapidly evolving field. Childhood neoplasia is generally not a public health priority in most developing countries. Although it is rare, pediatric cancer is a leading cause of childhood death in developed countries such as the United States. In the 1960s, almost 25% of global cancer burden was diagnosed in low-income and lower-middle-income countries. In 2010, nearly 55% of the global cancer burden was found in these countries.1 According to estimates from the International Agency for Research on Cancer (IARC), there were 12.7 million new cancer cases in 2008 worldwide, of which 5.6 million occurred in developed countries and 7.1 million in developing countries. Total cancer deaths in 2008 were 7.6 million (about 21,000 cancer deaths a day), 2.8 million in developed countries and 4.8 million in developing countries. By 2030, the global burden is expected to grow to 21.4 million new cancer cases and 13.2 million cancer deaths. Almost 9 million (about 70%) of these deaths will be in developing countries. By 2050, at the present growth rate, the chances of contracting cancer in their lifetime for the people living in developing countries will be 50-60%. Worldwide, approximately 10 million people are diagnosed with cancer annually and more than 6 million die of the disease every year; currently, over 22 million people in the world are cancer patients.4,5The cancer rate will increase from 650,000 to 2.2 million per year.4,5 In developed countries like United States, 11,600 new cases of pediatric malignancies are expected to be diagnosed in children aged 0-14 years in 2013. In 2008, GLOBOCAN has estimated that about 1, 48,000 malignancies in children aged 0–14 years occurred in less developed regions like Asia excluding Japan, Africa etc. having a population of 5.5 billion. There PEDIATRIC SURGICAL ONCOLOGY IN BANGLADESH: INCIDENCE AND PREVALENCE (GLOBAL & BANGLADESH)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121995193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Infantile hemangiomas are the most common soft tissue tumors in infancy, Systemic pharmacologic intervention is necessary for endangering, ulcerating, problematic, or life-threatening IHs . These include oral corticosteroid therapy as first-line treatment and interferon - alfa or vincristine as second- or third-line therapeutic agents. Since 2008, use of propranolol has come to the forefront because of its efficacy & minimal side effects. Aims and Objectives: The purpose of this study was to compare the efficacy of orally administered propranolol versus prednisolone versus both in the treatment of potentially disfiguring or functionally threatening infantile hemangiomas. Material and Methods: A prospective study of 24 patients aged 1 week to 12 years child with infantile hemangiomas was randomized into three equal groups. These were as follows: A, Propranolol (1–2 mg/kg/d); B, Prednisolone (1–2 mg/kg/d); and C, receiving both for a minimum duration of 3 months. Dimensions, color, consistency, ultrasonography, photographic documentation based on Visual Analogue Scale (VAS) were recorded before and periodically after starting treatment. A minimum 75% improvement was considered as success with no regrowth up to 1 month of stopping treatment. Results: Mean initial response time (days) in A (4.0 ± 3.3 SD) and C (4.5 ± 3.4SD) was significantly lower than B (8.79 ± 7.8SD) Significant change in consistency was noted very early in A (24 hours) compared to B (8days) and C (6 days). VAS results are as follows: (a) color fading—significant reduction in A within 48 hours compared to B and C (b) flattening— more significant and earlier in A and C than B ,and (c) mean reduction in size: significant in A and C at 3 months), 6 months whereas in B, it was seen only at 6 months. Conclusions: Though it’s a ongoing study, only result of 24 patient had been analysed. Propranolol had a consistent, rapid therapeutic effect compared to prednisolone. A combination of the two had a comparable but not higher efficacy than propranolol alone. Prednisolone was associated with a higher number of complications, thereby decreasing patient compliance. J. Paediatr. Surg. Bangladesh 5 (2): 41-44, 2014 (July)
{"title":"Comparison between the effects of Propranolol vs Prednisolone vs Prednisolone with Propranolol in the management of infantile hemangioma","authors":"S. Masud, K. Hasina, Muhammed Moinul Huque","doi":"10.3329/JPSB.V5I2.27722","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27722","url":null,"abstract":"Background: Infantile hemangiomas are the most common soft tissue tumors in infancy, Systemic pharmacologic intervention is necessary for endangering, ulcerating, problematic, or life-threatening IHs . These include oral corticosteroid therapy as first-line treatment and interferon - alfa or vincristine as second- or third-line therapeutic agents. Since 2008, use of propranolol has come to the forefront because of its efficacy & minimal side effects. Aims and Objectives: The purpose of this study was to compare the efficacy of orally administered propranolol versus prednisolone versus both in the treatment of potentially disfiguring or functionally threatening infantile hemangiomas. Material and Methods: A prospective study of 24 patients aged 1 week to 12 years child with infantile hemangiomas was randomized into three equal groups. These were as follows: A, Propranolol (1–2 mg/kg/d); B, Prednisolone (1–2 mg/kg/d); and C, receiving both for a minimum duration of 3 months. Dimensions, color, consistency, ultrasonography, photographic documentation based on Visual Analogue Scale (VAS) were recorded before and periodically after starting treatment. A minimum 75% improvement was considered as success with no regrowth up to 1 month of stopping treatment. Results: Mean initial response time (days) in A (4.0 ± 3.3 SD) and C (4.5 ± 3.4SD) was significantly lower than B (8.79 ± 7.8SD) Significant change in consistency was noted very early in A (24 hours) compared to B (8days) and C (6 days). VAS results are as follows: (a) color fading—significant reduction in A within 48 hours compared to B and C (b) flattening— more significant and earlier in A and C than B ,and (c) mean reduction in size: significant in A and C at 3 months), 6 months whereas in B, it was seen only at 6 months. Conclusions: Though it’s a ongoing study, only result of 24 patient had been analysed. Propranolol had a consistent, rapid therapeutic effect compared to prednisolone. A combination of the two had a comparable but not higher efficacy than propranolol alone. Prednisolone was associated with a higher number of complications, thereby decreasing patient compliance. J. Paediatr. Surg. Bangladesh 5 (2): 41-44, 2014 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121204087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Rattan, D. Garg, A. Rattan, Suresh Kumar Burolia
We are reporting two cases of primary omental hydatid cyst in children of 12 yr & 5yr of age respectively. Both cases were diagnosed on ultrasound & managed successfully by open surgical excision of the cyst. In our patients cyst were unilocular & in one of the patients it contained large numbers of daughter cysts (approx.150). We failed to find in literature a giant primary omental hydatid cyst with so many daughter scolexs of varying sizes. J. Paediatr. Surg. Bangladesh 5 (2): 68-72, 2014 (July)
{"title":"Primary Omental Hydatid Cyst:- Report of Two Cases","authors":"K. Rattan, D. Garg, A. Rattan, Suresh Kumar Burolia","doi":"10.3329/JPSB.V5I2.27728","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27728","url":null,"abstract":"We are reporting two cases of primary omental hydatid cyst in children of 12 yr & 5yr of age respectively. Both cases were diagnosed on ultrasound & managed successfully by open surgical excision of the cyst. In our patients cyst were unilocular & in one of the patients it contained large numbers of daughter cysts (approx.150). We failed to find in literature a giant primary omental hydatid cyst with so many daughter scolexs of varying sizes. J. Paediatr. Surg. Bangladesh 5 (2): 68-72, 2014 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130153310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Perioperative nutritional care for neonates, infants and younger children differ greatly from those seen in older children and adults. Nutritional care is essential for accelerated growth and development along with homeostasis and postoperative healing of pediatric surgical patients. Depletion of body stores decreased immunocompetence and increased mortality and morbidity is frequently associated with hyper metabolic state. Abdominal surgery is the most stressful factor leading to the reorganization of metabolic processes, redox homeostasis and immune changes. About 18% to 40% of pediatric surgical patients have malnutrition. Patients at risk for malnutrition are surgical patients, patients with large open wounds (concomitant loss of protein and increased metabolic needs), extensive burns, blunt trauma and sepsis.2 Individualized, adequate nutritional support in the peri-operative period decreases morbidity and mortality. Over past few decades mortality associated with surgery in children has rapidly declined. Refined respiratory care, antibiotics and improved nutrition with a greater knowledge of the needs of the surgical patients have together ameliorated the chances for surgical neonates and infants. 4
{"title":"Perioperative Nutrition in Pediatric Surgical Patients","authors":"K. Hasina, Sm Sabbir Enayet, A. Hanif","doi":"10.3329/JPSB.V5I2.27727","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27727","url":null,"abstract":"Introduction: Perioperative nutritional care for neonates, infants and younger children differ greatly from those seen in older children and adults. Nutritional care is essential for accelerated growth and development along with homeostasis and postoperative healing of pediatric surgical patients. Depletion of body stores decreased immunocompetence and increased mortality and morbidity is frequently associated with hyper metabolic state. Abdominal surgery is the most stressful factor leading to the reorganization of metabolic processes, redox homeostasis and immune changes. About 18% to 40% of pediatric surgical patients have malnutrition. Patients at risk for malnutrition are surgical patients, patients with large open wounds (concomitant loss of protein and increased metabolic needs), extensive burns, blunt trauma and sepsis.2 Individualized, adequate nutritional support in the peri-operative period decreases morbidity and mortality. Over past few decades mortality associated with surgery in children has rapidly declined. Refined respiratory care, antibiotics and improved nutrition with a greater knowledge of the needs of the surgical patients have together ameliorated the chances for surgical neonates and infants. 4","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122731478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Ahsan, H. Begum, M. Ahsan, Shamim Momtaj, M. Zahid
Objectives: To See the use of abdominal ultrasonogrphic in the diagnosis of Typhoid fever. Materials and Methods: This cross sectional study on enteric fever was carried out during the period of July 2008 to June 2009 on 30 patients between 2 months 12 years of age of either sex admitted with the clinical diagnosis of enteric fever having positive hemoculture for Salmonella typhi or paratyphi and or significant Widal test. Abdominal USG was done at Centre for Nuclear Medicine and Ultrasound, Bangladesh atomic energy commission, Sir Salimullah Medical College & Mitford Hospital. Result: On ultrasonogram, hepatomegaly observed in 93.3% cases, splenomegaly in 53.3% cases, thickened bowel wall in 46.7% cases, enlarged mesenteric lymph node in 63.3% cases and 30% cases showed gall bladder changes. Ultrasonogram was done on first week of fever in 33.3% cases, on second week in 43.3% cases and third week in 23.3% cases. Out of them ultrasonogram done on first day of admission in 6.6% cases, on second day in 80% cases and third day in 13.3% cases. In first week the bowel wall thickening found in 10% cases, lymph node enlargement in 23.3% cases and gall bladder changes in 3.3% cases, in second week the bowel wall thickening found in 23.3% cases, lymph node enlargement in 26.6% cases and gall bladder changes in 20% cases, in third week the bowel wall thickening found in 13.3% cases, lymph node enlargement in 13.3% cases and gall bladder changes in 6.6% cases. Sonologic findings of bowel wall thickening, lymph node enlargement and gall bladder changes found in 23.33% cases in 1st week, 33.33% cases in 2nd week and 13.33% cases in 3rd week. Conclusion: In endemic areas like Bangladesh ultrasound findings of hepatomegaly, splenomegaly, mesenteric lymphadenopathy, bowel wall thickening, gall bladder changes are useful diagnostic features of typhoid fever. J. Paediatr. Surg. Bangladesh 5 (2): 58-63, 2014 (July)
{"title":"Abdominal Ultrasonogram in Typhoid Fever: A Useful Diagnostic Tool","authors":"K. Ahsan, H. Begum, M. Ahsan, Shamim Momtaj, M. Zahid","doi":"10.3329/JPSB.V5I2.27726","DOIUrl":"https://doi.org/10.3329/JPSB.V5I2.27726","url":null,"abstract":"Objectives: To See the use of abdominal ultrasonogrphic in the diagnosis of Typhoid fever. Materials and Methods: This cross sectional study on enteric fever was carried out during the period of July 2008 to June 2009 on 30 patients between 2 months 12 years of age of either sex admitted with the clinical diagnosis of enteric fever having positive hemoculture for Salmonella typhi or paratyphi and or significant Widal test. Abdominal USG was done at Centre for Nuclear Medicine and Ultrasound, Bangladesh atomic energy commission, Sir Salimullah Medical College & Mitford Hospital. Result: On ultrasonogram, hepatomegaly observed in 93.3% cases, splenomegaly in 53.3% cases, thickened bowel wall in 46.7% cases, enlarged mesenteric lymph node in 63.3% cases and 30% cases showed gall bladder changes. Ultrasonogram was done on first week of fever in 33.3% cases, on second week in 43.3% cases and third week in 23.3% cases. Out of them ultrasonogram done on first day of admission in 6.6% cases, on second day in 80% cases and third day in 13.3% cases. In first week the bowel wall thickening found in 10% cases, lymph node enlargement in 23.3% cases and gall bladder changes in 3.3% cases, in second week the bowel wall thickening found in 23.3% cases, lymph node enlargement in 26.6% cases and gall bladder changes in 20% cases, in third week the bowel wall thickening found in 13.3% cases, lymph node enlargement in 13.3% cases and gall bladder changes in 6.6% cases. Sonologic findings of bowel wall thickening, lymph node enlargement and gall bladder changes found in 23.33% cases in 1st week, 33.33% cases in 2nd week and 13.33% cases in 3rd week. Conclusion: In endemic areas like Bangladesh ultrasound findings of hepatomegaly, splenomegaly, mesenteric lymphadenopathy, bowel wall thickening, gall bladder changes are useful diagnostic features of typhoid fever. J. Paediatr. Surg. Bangladesh 5 (2): 58-63, 2014 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125690651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The outcome of intestinal atresia following surgical repair is very good. In general, morbidity and mortality depend upon type of atresia, level of atresia and associated medical conditions such as prematurity or cystic fibrosis, other congenital anomalies, the complexity of the lesion, and surgical complications (anastomotic leakage, functional obstruction at the site of anastomosis).1- 2 But complete management of these patient is difficult. We managed a patient with type-IIIa ileal atresia, the outcome of which was excellent. J. Paediatr. Surg. Bangladesh 3 (2): 85-87, 2012 (July)
{"title":"Intestinal Atresia : A Case Report","authors":"M. Hossain, Ashraful Huq Kazal, Moinul Huque","doi":"10.3329/JPSB.V3I2.23923","DOIUrl":"https://doi.org/10.3329/JPSB.V3I2.23923","url":null,"abstract":"The outcome of intestinal atresia following surgical repair is very good. In general, morbidity and mortality depend upon type of atresia, level of atresia and associated medical conditions such as prematurity or cystic fibrosis, other congenital anomalies, the complexity of the lesion, and surgical complications (anastomotic leakage, functional obstruction at the site of anastomosis).1- 2 But complete management of these patient is difficult. We managed a patient with type-IIIa ileal atresia, the outcome of which was excellent. J. Paediatr. Surg. Bangladesh 3 (2): 85-87, 2012 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115114856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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